An interesting article titled “Antibiotic resistance: The silent pandemia” appears in the International Dental Journal on January 12 2023 written by Angel-Orión Salgad Peralvo and et. al. The article discusses a call to action for dentists worldwide to cut back on their antibiotic prescribing habits arguing that 66% of antiobitics prescibed is not warranted.
In the article the authors mention that dentists prescribe 10% of all antibiotics in the world. However, the way they see it, antibiotics being overly prescribed can contribute to the worldwide development of antimicrobial resistance. Antibitoics are used in dentistry for preventive purposes and to avoid systemic bacteraemia in patients at risk or to prevent possible bacterial contamination during surgery. Yet the resistance problem increases medical costs and increases mortality. Therefore they feel that dentists should change the way they prescribe antiobitics as the resistance problem will just continue to pose a serious threat. The authors estimate that resistance is responsible for more than 700,000 deaths per year globally and the costs associated are atleast 9 billion euros per year in the European Union and 55 billion dollars per year in the United States. They estimate that without drastic action, in 2050 antibiotic resistance will be responsible for 10 million deaths worldwide.
As at relates to dentistry, the authors point out that analysis of bacterial pathogens from odontogenic infections found microorganisms, Streptococcus spp. and Staphylococcus spp. that were resistant to penicillin and aminopenicillin and also showed resistance to clindamycin and macrolide. The authors recommend that dentists are familar witht the three prevention levels of antibiotic resistance in dentistry. The first primary prevention is when dentists should discuss with their patients on how to use antibiotics correctly according to the prescribed dosage and discuss with them the harm of not using antibiotics correctly. Based on guidelines from scientific societies, antibiotics should be given at least one hour before surgery to allow for adequate concentration in the blood. The second secondary prevention is based on the detecting of antibiotic resistance and reporting resistant infections to drug safety agencies. The third, tertiary prevention is performing cultures and antibiograms in the presence of infections and identifying the susceptibility of germs to different types of antimicrobials.
The authors state:
“[antibiotic] treatment durations are recommended to be as short as possible, but sufficiently effective to kill the bacteria present”
It is hopeful that dentists can do their part to help allow for antibiotics to continue to be effective against the hundreds of bacterial species in the oral cavity.